Thursday, September 5, 2013

My own worst enemy

As most of you probably know about me, I am a sufferer of migraines. And have been, since age three.

This means it's been a solid 25 years of dealing with this situation. I'll call it a situation because by now it's pretty much faded into oblivion. I count myself fantastically fortunate that they have reduced themselves into almost nothing. As a kid I used to get about one a week, sometimes more. This was before I had sorted out all my food triggers, stress triggers, all the wonderful other triggers that life just has that I didn't know about until experience had sussed them out (female-related triggers, depression and anger triggers, sleep and exercise triggers, weather name it).

The food triggers were my biggest ones. It took me years to associate chocolate, caffeine, ricotta and American cheeses to the list. It took me slightly less time to see that certain types of anger, stress, and depression also triggered bad attacks. Lack of sleep, lack of exercise. Sudden changes in the weather. I think you can all see why I'm a little bit nuts and my lifestyle is the way that it is (e.g. half marathon runner, little more than avid gym-goer...little more than your average food nut and strict non-coffee drinker).

My migraines have taught me the glory of balance and a healthy lifestyle. The more I adhere to this strict regulation of goodness, the less pain I have to suffer. It is like walking on a balance beam. But you like walking on this balance beam...because falling off the beam hurts like hell. Hurts for 8-12 hours. So you stay on the balance beam as much as possible...and oddly this makes you a healthier all the ways society also agrees with, so it usually works out for the best (I guess).

Anyway, it'd been almost two years since my last migraine. So long in fact that I'd stopped carrying my emergency migraine cocktail (this unfortunately is not an actual booze-based drink but rather a threesome of pharmaceuticals that is used to eradicate the effects of a migraine within half an hour...potent triangle, I can tell you that), which I used to carry with me at all times, and I had stopped recording a headache diary, something I'd been doing since highschool. This is a journal where you record the status of pain everyday. If you had a migraine that day you'd record the gory details of the affair: how long the aura lasted, did it pulsate, was there nausea, how long did the nausea last, did you in fact throw up, how bad was the pain, which side was the pain on, what kinds of medications did you try to use, when did you take them, how effective were they, what other kinds of treatments did you use (ice pack, medical bandage strip, acupressure, etc). This thing got fairly extensive.

And then, out of the blue, as I was rather jovially getting ready for work one morning, BOOM. Aura at 8:06am. Sigh, reset the headache clock.

Before I lost my vision for the next several hours, I sent out an email to my team telling them I was going to take a sick day. One of the many great side effects of an attack - losing the majority of my vision for awhile.

I then had the startling realization - since I was still at home...I could take the cocktail! So I did. First time in years (normally I just take a naproxen and call it a day, since that's all I have on me when attacks happen).

I then fell asleep for another three hours. Blissful oblivion sleep. Well, not that blissful since I'd only really been awake for that half an hour or so of getting ready then I was immediately asleep again, but I guess my body really needed it because I had no trouble falling asleep again for those three hours. It was the uncomfortable kind of sleep though; the sticky sleep, as I like to call it. But whatever, necessary. I woke up with a minimum of headache pain (as far as my journal would have described it). So I got myself up (all the blinds in my apartment drawn tightly shut) and tottered around the house bearing the pain the rest of the day.

One thing I will say about the cocktail (which I had remembered, before taking it): it makes me loopy for about 24 hours. It does make the pain significantly less and my vision return a lot faster (which is really nice), but it makes me spacey and a bit weird. My logic goes out the door for awhile and I sometimes have weird responses to people's questions, so I tend to stay away from people as much as possible the next day if I can avoid it. Not always possible when you hold a professional job and whatnot. Let's just say it wasn't the most productive day the next day...and my email correspondence may not have been completely sensical.

Since I'll not go into the details of what the pain was like or any of that, I'll instead explain the scientific description of what having a migraine is like (or what I've understood it to be).

Basically something causes my brain to react in a funny way, kind of like someone having a seizure (actually they're quite similar in lots of ways). There is a pinpoint of electrical activity that goes haywire somewhere in my brain.

Instead of dealing with it like a normal brain though, it continues across that entire lobe of my brain and spreads to the other lobe, like an electrical storm. This happens in seizure patients as well though theirs causes a loss of control of their bodies and hence the seizing. Luckily mine doesn't cause electrical storm causes things like...

Increased blood flow to the vessels in and around my brain. This causes them to gorge and swell with excessive blood, which in turn presses on the nerves around my temples, scalp, and especially my eyes. This causes the visual disturbances I get (pressure on my optic nerve) and the pulsating, hammering pain I get in my head and temples.

It also causes, as a side effect, my other systems to shut down, like my digestive system. No more blood over there to keep those systems going. So unfortunately there is a very limited window of opportunity from the time I see my aura to the time I can take medication and expect it to work. It's about 20 minutes or so; anytime after that and my digestive system has already stopped working; no more help will be able to get in...the gates are closed. Trust me; at one point in my life I tried almost everything out on the market for migraines (injections, nasal sprays, dissolvable under-the-tongue tablets that were supposed to seep into your blood stream, etc.)...we all know about the digestive system problem...hence the different methods. I didn't find anything that resonated with me though, so...none of those stuck.

Anyway, along with all of these things because there is an unusually large amount of blood in the brain (among other things, since not all of these things can be explained scientifically), there is also a heightening of the senses - sensitivity to light, sound, and smell. Gotta shut off the world and put yourself into a sensory deprivation field of comfort. Sometimes everything is slightly uncomfortable because your body is trying to fight off itself. I already have a heightened sense of smell and taste all the time, but it is magnified. Not that you want to eat anything anyway because most of the time you're nauseous and will really let go of anything you have in your stomach (side effect of your digestive system shutting down - all systems will flush...literally). Sometimes I would throw up so hard and for so long that I would barely me able to get in a breath before it started again. I will say that it gave me incredible stomach muscles, which I still retain, but this is a strange prize for so big a trial.

At the end of the day you emerge weak but happy that the pain is over. You're usually emaciated and extremely dehydrated but just joyful at being alive and not in pain. You gladly drink soup or whatever you can keep down (you want something soft and salty and easy to eat, nothing offensive or overly mom used to make me chicken ramen with peas and no was heaven). I remember those moments of childhood as being the calmest and quietest. Like having gone through the battle of my life and realizing, suddenly, the war was over and I had quite shockingly, survived.

As a kid I used to wonder if I had done something horribly wrong to deserve all the pain. Like each time an attack came it was because I had done something bad and this was my punishment. Each time I emerged, weak as I was it was like I was cleansed and could start anew; it was like a reset button. I've continued to think along similar lines as an adult: too much excess causes the attacks and the attack is my body pushing the reset button. But at least I know the triggers now so I walk the beam carefully now and rarely fall off.

Generally speaking we all thought that these would end sometime as I reached the end of university. That's when my dad stopped having his. But alas they have continued, despite improved medication (of which I still take two prescriptions daily to prevent my attacks) and lifestyle research. I guess I'll just wait my turn.

In the end I'll leave you with this: having this, although it's been a hard thing to bear at times, has had its well-worth lessons. Certainly I know more about myself than I would have ever dared ordinarily and I hope people continue to do good research about this so my children, should I be so horrible and pass it onto them, will not have to suffer as I have.

Here are some studies that have been done on migraine aura art. These are visual representations made by people like me who have tried to show others what their auras look like. This is similar to what I see. I've thought about making my own art at some time...but it would take an extreme leap of faith on my part and I'm not sure I'm ready for that. Maybe when they're finally gone from my body, I'll feel strong enough for that.

Until then, thanks for listening.

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